Tenforde MW, et al. - Mortality and predictors of mortality were investigated in adults evaluated for meningitis in Botswana, which has an estimated 23% HIV prevalence among adults. From the Botswana national meningitis survey, a nationwide audit of all cerebrospinal fluid (CSF) laboratory records from patients receiving a lumbar puncture for evaluation of meningitis, researchers obtained data of 238 patients with culture-confirmed pneumococcal meningitis, 48 with culture-confirmed tuberculous meningitis, and 2900 with culture-negative CSF (including 1691 with CSF white cell count (WCC) of up to 20 cells per μL and 1209 with CSF WCC above 20 cells per μL). This setting of high HIV prevalence showed high mortality from pneumococcal, tuberculous, and culture-negative meningitis. Findings highlight the urgent necessity for enhanced access to diagnostics, to better define aetiologies and generate novel diagnostic tools and treatment algorithms.